Many Facets of Medical Populism: British Political Tradition (BPT) and Covid-19

The traditional British political style and rhetoric were utilized by both former Prime Minister Boris Johnson and Nigel Farage of UKIP as tools to communicate their approaches to managing the COVID-19 crisis. This demonstrates the resilience of established political traditions while highlighting the volatility and ambiguity of populist strategies. Notably, populist narratives varied significantly depending on whether the leader was in power or in opposition, which influenced their responsibility towards citizens and their ability to connect populist grievances with pre-existing political arguments in the context of the pandemic. In particular, Johnson’s actions reflect a ‘government knows best’ approach to the crisis, blending epistemic and political authority in determining the necessary measures to address the pandemic.

By Andrea Guidotti*  

Introduction

This paper analyzes the role and significance of the Covid-19 pandemic in the development and behavior of British populist parties. It aims to observe how and when the so-called British Political Tradition (BPT) has been used by these parties as a guiding principle warranting the actions and policies implemented during the Covid-19 crisis in the UK. First, it will briefly introduce medical populism from a general perspective and within the specific situation of the Covid-19 pandemic. Second, it will analyze the overall actions taken by the two main British (right-wing) populist parties at the time and their leaders: the Conservatives in power under Prime Minister Boris Johnson and Nigel Farage’s UKIP party. This piece is not intended to be a theoretical discussion regarding the populist status of the considered parties and assumes that both can be meaningfully characterized as consistently (but differentially) populist on a variety of issues – such as health, immigration, economics or Brexit. The final section discusses the relationships between populists’ responses to the pandemic and the BPT. It evaluates if populists’ attitudes towards COVID-19 and its political management are positively affected by the BPT.

Populism and the Pandemic

One must first understand what kind of crisis the COVID-19 pandemic was and, thus, what kind of phenomena populists were dealing with at the time. Some scholars conceive a crisis as a moment of saliency for systemic contradictions and a consequent perceived need for structural change and strong interventions to take place. In such a situation, political agents are overwhelmed by the unfolding events and there is no common recognized rationality for handling the crisis-driven situation (Bobba & Hubé, 2021: 3).

Under a dynamic conception of crises, populist actors may be better conceived not just as passively reacting to given external shocks, but “as actors that actively perform and spread a sense of crisis” (Bobba & Hubé, 2021: 6). This is a general characterization of an endogenous crisis, where all the contradictions are generated within the political system, and in which political agents are acting. In other words, when confronted with such a scenario, populists from all over the political spectrum usually tend to at least trigger or even manufacture the crisis themselves to gain some leverage in the political system (Ringe & Rennó, 2023: 4). Being an exogenous crisis with respect to populism, the pandemic is harder to politicize than other political shocks or events that are at least partially originated inside the system itself. In addition, it should also be noted that the pandemic has a peculiar nature: as a public health crisis, no one is free from its consequences and implications. 

Bobba & Hubé (2021: 9-10), drawing from other authors, use the following general framework to better understand health crises such as Covid-19. Health crises are thought to be divisible into three parts: (a) an initial phase in which you are confronted with the emergence of the problem; (b) a confrontation phase in which some actors blame other actors for being responsible for what is happening; (c) a managing phase in which who is blaming responsibility upon others generally tries to propose and claim its solutions.

Moving to populism to connect it with the pandemic, a meaningful characterization of the term in the context of public health crises is needed. Following Gideon Lasco’s argument (2020: 1), one could say that “medical populism” is “a political style based on performances of public health crises that pit ‘the people’ against ‘the establishment’.” Different examples of medical populism can be given, going from Jair Bolsonaro downplaying the threat of the virus and pitting the economy against public health policies, to Donald Trump paving the way for conspiracy theories about the virus’ creation and blaming illegal immigrants for its spread around the country. 

With specific reference to Covid-19, we can distinguish some main features of populist strategies acting within such a crisis: (i) the simplification of the pandemic, offering the simplest (and most simplistic) solutions to the problems that the health emergency is posing; (ii) the dramatization, distortion and spectacularizing the threats posed by the crisis; (iii) the forging of societal divisions claiming to be on the side of the ‘real people’ quite often opposed to an unspecified ‘otherhood’; (iv) the invocation of knowledge claims: for example with regards to the virus’ origins, about the most appropriate methodologies to prevent its spreading or on how to treat it consistently (Lasco, 2020: 2-3). 

Investigating the second feature of populism (ii), we can add the fact that populist actors must not be obscured by the coverage of the pandemic itself. They need to spectacularize the crisis with their messaging, a strategy that allows them to stand out as relevant and influential figures in the public and online media to claim reliability and legitimacy properly (Ringe & Rennó, 2023: 5). 

Regarding the third feature (iii), it is difficult to frame the populist concept of the ‘real people’ alongside the strategy of pitting them against other groups or entities when the virus indiscriminately affects everyone. Being aware of this problem, “‘the people’ are imbued with various characteristics, biomedical and otherwise [with populists] claiming that their citizens are less susceptible to the virus” (Lasco, 2020: 4-7). Thus, the ‘others’ against which populists claim to fight in representation of the “real people” during the pandemic are generally international and supranational actors such as the WTO or other states such as China – if not intellectual elites such as academics, journalists or public health experts (Bobba & Hubé, 2021). 

Points (i) and (iv) are strictly intertwined in that simplification goes hand in hand with false claims and controversial scientific statements. In other words, we observe a “widespread deployment of scientific language and imagery – and a selective deployment of scientific consensus” (Lasco, 2020: 8).

British Populism and Covid-19

To better connect British populism with the case of the pandemic, it is useful to get a brief and general background of the previous relationships between populism and healthcare policies in the UK before Covid-19. There is a distinction between healthcare systems that are more or less resistant to populist performances. The former are well-resourced, present a developed network-based model of governance, and involve professions in the policy processes. On the contrary, the latter are poorly financed, present high levels of command along the line of the New Public Management-type (NPM) governance model and display low trust in healthcare providers (Speed & Mannion, 2020: 3). 

But the most important thing to recall regarding the evolution of the British healthcare system (NHS) and populism is the BREXIT process. During those years, right-wing populists argued that by leaving the European Union (EU) more funds could be allocated to better finance the NHS. Specifically, they framed the unsustainability of the NHS and its underdevelopment (mostly in terms of funds and available high-skilled personnel) as a problem of immigration, as the blame was directed towards immigrants enjoying health services paid for by British citizens (Speed & Mannion, 2020: 8). 

Johnson and the Conservatives

The Conservatives, led by then Prime Minister Boris Johnson, were in power when Covid-19 became a global medical problem, and remained so until the end of the pandemic. For some authors (Sahin & Ianosev, 2021), the first wave of the pandemic, from February 2020 to roughly July 2020, can be divided in three phases. The ‘breakout’ phase was characterized by state authorities acting in a relaxed way, without invasive governmental control over people’s freedoms. This moment corresponds to the public’s response to the news about the virus’ spreading. During the ‘confrontation’ phase, the virus’ infection began widely spreading, and the number of people testing positive to Covid-19 began to grow exponentially. The final, ‘managing,’ phase is characterized by attempts to stabilize the situation and enforce measures in order to cope and coexist with the virus while waiting for the development of vaccines. 

During the first two phases the Conservative Party did not take the risks seriously and showed a libertarian way of thinking, arguing against a strict and hard response to the crisis in terms of closures and restrictions. In particular, Prime Minister Johnson did not attend the meetings dedicated to the government’s response to the pandemic in early February 2020 and criticized some warnings made by the British Scientific Advisory Group for Emergencies (SAGE) (Bale, 2023: 69-70). An explanation for that could be that his actions and public statements were influenced and warranted by ‘misplaced optimism’ and regressive and nationalistic ideas, historically speaking, of the British role in the world – stressing the narrative around the exceptionality and efficiency of the NHS (Sim & Tombs, 2022: 6). 

Starting from the end of March and the beginning of April, things became more dramatic, and the Prime Minister Johnson’s attitude changed. Around this time the first lockdown was issued, disregarding the idea of ‘herd immunity’ where the virus is left to spread in the population to lower its virulence (Sahin & Ianosev, 2021: 21). In general, the government stressed conventional public measures and followed international guidelines along other major Western and European states (Bale, 2023: 70). Additionally, Johnson’s Cabinet avoided using tropes potentially contributing to the politicization of the crisis, and attempted to emphasize the importance of scientific guidelines (Sahin & Ianosev, 2021: 26). 

Analyzing the rhetorical repertoire that has been used, the governmental discourse historically situated Covid-19 in mainly three different ways. To do so, the Cabinet used so-called ‘temporal claims,’ as defined in narrative discourse theory. Following the construction of a (i) radically discontinuous time, the virus has been described as a moment of generational significance. The pandemic was to be seen as an unprecedented event disrupting people’s habits and usual social behavior, in order for new economic, social and political initiatives to be ruled and legitimized. From another point of view, events have been plotted with a (ii) linear timeline, positing a unidirectional and cumulative development. Here, a descriptive account of some sequences and a principle of evaluation of the events and by which to assess the correctness of the action leading to their unfolding have been invoked. Lastly, the construction of a (iii) cyclical time helped the government to depict everyday life after the pandemic in a radically different way. In this respect, narratives were prospecting and sketching the idea of a ‘new normalcy’ bringing the emergence of new habits for everyone (Jarvis, 2021: 27-31).

To conclude this investigation of Johnson’s political communication during the pandemic, it is notable that he also employed daily governmental press briefings, using so-called the ‘numbers arms race’ and more broadly the already cited ‘war language.’ Both of them served as an enforcement to the claim of fighting for Britain in a once in a lifetime event. The key mantra has been the following statement: “Stay Home, Protect the NHS, Save Lives” (Sim & Tombs, 2022: 9-10). 

Farage and the UKIP

In contrast to Johnson, who avoided politicizing the pandemic, Nigel Farage opted to fully utilize a populist political communication style typically associated with right-wing parties. Despite taking a cautious stance at the beginning of the breakout, he started acting as a radical libertarian, opposing public health restrictions and showing his open skepticism about government actions towards the pandemic (Bale, 2023). 

Two major critiques can be identified. The former critique strictly concerns the governmental actions taken when the health situation started being very problematic. Farage accused Johnson’s government of incompetency and indecisiveness in dealing with the crisis, framing his actions as a lack of leadership on the side of the Prime Minister (Sahin & Ianosev, 2021: 27). His arguments are composed by a mixture of “support for draconian measures on ‘law and order’ and ‘Britain’s borders’,” and “its essentially libertarian opposition to ‘political correctness gone mad’ as well as ‘red tape’ and the ‘faceless bureaucrats’” (Bale, 2023: 71). Resorting to well-known populist grievances, alongside other world leaders such as Trump, he adapted the issue of immigration and the concerns associated with it in claiming that migrants could enter and spread the virus if police enforcement on British borders were not sufficiently severe or incoming international flights were to be easily allowed for foreign travelers coming from high-risk countries (Sahin & Ianosev, 2021: 23). He also denounced the ‘herd immunity’ strategy initially sought to be pursued by the government, although he maintained a libertarian posture by stressing the fact that measures taken to stop the virus’ transmissibility were not meant to become a “house arrest” for the entire nation (Bale, 2023: 72). 

The latter part of his narratives, and the second critique he posed, is about the role of the UK in the world and the attempt to identify responsible actors for the pandemic to occur. In other words, he blamed China for not telling the truth about Covid-19’s emergence in the first place and for its deliberate suppression of key information and the intentional delaying of their communication to the international community (Bale, 2023: 71). Concisely: “While the government undermined the seriousness of the crisis mostly because of economic concerns, Farage opportunistically used the COVID-19 crisis to suggest a scale down to the UK’s relations with the EU and China” (Sahin & Ianosev, 2021: 26).

The British Political Tradition in Times of Crisis

According to Lijphart (1999), the British Westminster Model presents nine core tenets: (1) the concentration of the executive power in one party; (2) cabinet dominance; (3) a two-party system, where parties produce manifestos and seek a mandate to govern; (4) a majoritarian electoral system; (5) a unitary and centralized government; (6) interest group pluralism; (7) the concentration of legislative power in Parliament; (8) constitutional flexibility; (9) the central bank is controlled by the executive. Following Hall (2011: 9-10) and Richards and Smith (2002)  we can add two more tenets: (10) the doctrine of ministerial responsibility; (11) a permanent, neutral, and anonymous civil service. 

What is important to us here is the fact that the Westminster Model emphasizes some peculiar aspects. First, a linear and gradual development of the British political system and its institutions. Second, it stresses a great degree of British exceptionalism, and the superior nature of its system compared to other Western ones. Third, it is warranted by the idea that power is to be concentrated and exercised with a top-down approach. Warranting this system, according to Hall (2011: 124-125), the British Political Tradition (BPT) could be characterized as presenting the following main themes: (i)A discourse that stresses a limited liberal notion of representation and the elitist view that politicians are best suited to make decisions on behalf of the populace […] and are willing to act against the expressed will of the public or in the face of substantial public opposition; (ii) A discourse that stresses a conservative notion of responsibility and the view that a strong, decisive government is the most effective, efficient and desirable form of government. […] (iii) A discourse about change which emphasizes the virtues of continuity, gradualism, flexibility and stability. […] (iv) A discourse concerning a sense of British distinctiveness and superiority politically (Hall, 2011: 124-125)

Regarding discourse (i), it must be added that the BPT is sustained by an elitist conception of democracy, particularly the famous ‘Westminster and Whitehall know best’ statement, which itself reflects the interest of the political elite, thus reinforcing their status and power (Marsh & Hall, 2016: 128). The BPT reifies over time already existing inequalities and asymmetries in the British political system between citizens. Therefore, these ideas and beliefs have been mostly supported by most of the population. This results in the populace developing a somewhat deferential attitude towards politics, where politicians are seen as the best holders of the right to take the most important and crucial decisions for all (Hall, 2011: 159). Moreover, Marsh and Hall rightly highlight that the BPT not only served the interest of the political elite, but also of the socio-economic one. Specifically, regarding discourse (ii) above, the climax of political conservatism made it easier for the working class to accept the status quo. Furthermore, the dominance of the executive power helped political elites to enact policies more favorable to the socio-economic ones without too much opposition (Marsh & Hall, 2016: 135). 

Johnson and the BPT

The discussion seems to beg the question: Has the BPT influenced the populist (Johson and Farage) behavior described above? Following Finlayson et al. (2023), we can observe the employment of several traditional tropes dating back to the language and discourse of the BPT. Particularly, Prime Minister Johnson’s behavior indicates the presence of a ‘government knows best’ approach to the crisis, merging epistemic and political authority over the actions needed to cope with the pandemic. For example, the invocation of the concept of ‘the people’ is used to hide the public’s limited political agency and retain the rights and legitimacy over the enactment of the counteracting measures. All of this is also related to the low participatory governance tradition inherent in the British State, but also shows how Johnson proved to strategically build its narrative of the pandemic to advance and increase the further legitimization of past policy decisions, and in particular the ones connected with the Brexit process (Wellings et al., 2023: 238). The former British premier revitalized the concept of the ‘British people’ within the public imagination, employing the sustainability and functioning of the NHS and other health issues as an element of continuity in his narratives from the beginning of the ‘Leave Campaign’ for Brexit to their management during the pandemic (Welling et al., 2023: 242). 

To better understand the British government’s communicative repertoire, the authors identify four main figurations of ‘the people’ (Finlayson et al., 2023: 344). First, we have ‘statistical realities.’ Here, ‘the people’ are represented and aggregated numerically, thus appearing more as abstract elements that legitimize the quest for acquiescence from the government (Finlayson et al., 2023: 345-346). Put another way, this kind of framing not only confers to the Cabinet epistemic authority because numbers don’t need further explanations, but also certifies its tight cooperation with the scientific community (Massidda & Sacca, 2023: 222). 

Second, we have the figuration of ‘suffering families.’ This narrative aims to develop a public ‘ethos’ via which it can acquire the rights and legitimacy required to advance its policies. The BPT here is involved and works when this communicative strategy properly connects governmental instructions with people’s feelings, needs, and emotions – knowing what is best to accomplish them (Finlayson et al., 2023: 347). 

Third, ‘the people’ are framed as responsible individuals. This one is seen as a rule follower, encapsulated in a hierarchical structure that crystallizes a top-down and vertical conception of the people/state relationships. Once again, the BPT widens the divide between the elites and the public. ‘The people’ are required to follow the moral claims encouraged by the elite to fulfill their individual and collective responsibilities and duties towards resolving the crisis. The individual responsibility regards the task that people are assigned to complete, such as wearing protective masks in public spaces while avoiding unnecessary contact with strangers. The collective responsibility is rooted in utilitarian reasoning: complying with the rules means a faster crisis resolution (Finlayson et al., 2023: 348-349). 

The second and third depictions help understand the way in which Johnson tried to preserve its populist-driven consensus from the backlash of its unpopular decisions during the crisis. He tried not only to highlight the community as a collective as the real protagonist of the effort to fight against the virus’ infection, but also to present himself as a transparent and compassionate leader (Massidda & Sacca, 2023: 209-215). 

The fourth and final depiction utilized is ‘freedom-loving citizens.’ This time, citizens are represented as rights holders and interests to be appropriately recognized. Consequently, the government has a duty to protect these fundamental freedoms and, by showing the truth about them, affirm the legitimacy of its guidelines (Finlayson et al., 2023: 350). 

Farage and the BPT

The case of Farage is different. Being an oppositional force during the COVID-19 pandemic breakout, it was much easier for him to resort to typical and proven to be more effective populist grievances. However, the BPT resonates consistently in Farage’s discourses during the crisis: I’m convinced that its influence is evident when the UKIP’s leader blamed Johnson for his lack of leadership and inefficient management in the initial months of the crisis development. Specifically, Farage used his oppositional platform on health policies to rally against the government and exploit the newly achieved consensus to fuel support around the rebranding of UKIP in ‘Reform UK’ (McManus, 2021: 148-150). 

Relating to discourse (ii) presented before, I argue that Farage somewhat recalls the necessity for the executive to be strong and decisive in its actions on behalf of the State. Second, and about discourse (iv) discussed above, I argue that Farage recalls the BPT when he stresses the role of the UK in the world vis-à-vis the actions and warnings undertaken towards China by other Western leaders. Put another way, he tried to point out the distinctiveness and peculiarity of the British political system as opposed to others, especially in the Western World, while asking for a different resolution path for the crisis (Bale, 2023; Sahin & Ianosev, 2021). 

Overall, even if Farage was not in a position that favored traditional forms of British political thinking, the BPT proves to have (at least) partially influenced his claims and actions during Covid-19’s unfolding. 

Conclusion

To recall the main points of the argument above, there is clear evidence that the British Political Tradition (BPT) still influences how politicians behave in ordinary British political life and their policy-making choices. Even in the face of essential shifts and changes caused by the Covid-19 crisis, many political actors tried to adapt these new challenges to the long-standing historical and common way of interpreting political actions and decision-making in the UK (Hall et al., 2018: 15). 

The aim of this article was to check for the influence of the BPT on populist leaders. As we observed, the British traditional political style and tropes served both Johnson and Farage as a means to instill their ideas about how to manage the crisis. This proves the resilience of established political tradition and clarifies the volatility and ambiguity of the populist repertoire and strategies. Regarding the latter point, populist narratives varied a lot depending on two factors: (i) the position of the leader – being in charge or standing as an oppositional force – and hence its responsibility towards citizens; (ii) the ability to legitimately connect populist grievances in the context of the pandemics with already existing lines of political reasoning. Some examples exemplifying the second point are the case of migration and the issue of border control regarding the likelihood of importing and spreading the virus uncontrolled. 

(*) Andrea Guidotti is a master’s student at the University of Pavia and an intern at the ECPS.

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